[1]周世博,陈海龙△,郑九琴,等.Ⅰ期全麻洛阳正骨手法在下颈椎骨折脱位前路手术复位中的应用[J].中国中医骨伤科杂志,2025,33(03):72-75+80.[doi:1005-0205(2025)03-0072-04]
　ZHOU Shibo,CHEN Hailong,ZHENG Jiuqin,et al.Clinical Study of Luoyang Bone-Setting Manipulation in Anterior Surgical Reduction of Lower Cervical Fracture Dislocation under Stage Ⅰ General Anesthesia[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2025,33(03):72-75+80.[doi:1005-0205(2025)03-0072-04]
点击复制

Ⅰ期全麻洛阳正骨手法在下颈椎骨折脱位前路手术复位中的应用()
分享到：

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第33卷
期数:
2025年03期
页码:
72-75+80
栏目:
临床报道
出版日期:
2025-03-15

文章信息/Info

Title:
Clinical Study of Luoyang Bone-Setting Manipulation in Anterior Surgical Reduction of Lower Cervical Fracture Dislocation under Stage Ⅰ General Anesthesia
文章编号:
10.20085/j.cnki.issn1005-0205.250313
作者:
周世博1;  陈海龙1; 2△;  郑九琴1;  朱文潇1;  马俊杰1;  朱博1;  张红星1;  张馨丹3
1河南省洛阳正骨医院(河南省骨科医院)(河南 洛阳,471002)
2河南中医药大学
3湖南中医药大学
Author(s):
ZHOU Shibo1;  CHEN Hailong1; 2△;  ZHENG Jiuqin1;  ZHU Wenxiao1;  MA Junjie1;  ZHU Bo1;  ZHANG Hongxing1;  ZHANG Xindan3
1Luoyang Orthopedic-Truamatological Hospital of Henan Province(Henan Provincial Orthopaedic Hospital),Luoyang 471002,Henan China; 2Henan University of Chinese Medicine,Zhengzhou 450046,China; 3Hunan University of Chinese Medicine,Changsha 410208,China.
关键词:
Ⅰ期全身麻醉;  洛阳正骨手法;  颈椎前路手术;  下颈椎;  骨折脱位
Keywords:
stage Ⅰ general anesthesia;  Luoyang bone-setting manipulation;  anterior cervical surgery;  lower cervical spine;  fracture and dislocation
分类号:
R683.2
DOI:
1005-0205(2025)03-0072-04
文献标志码:
B
摘要:
目的:探索Ⅰ期全麻洛阳正骨手法复位联合颈椎前路手术治疗下颈椎骨折脱位的临床疗效。方法:回顾性分析2020年8月至2023年1月接受Ⅰ期全麻洛阳正骨手法复位+颈椎前路手术的下颈椎骨折脱位患者。建立Excel数据库,以VAS评分、JOA评分、ASIA评分、手术节段高度以及末次随访时椎间融合率为观察对象,分析患者术前及末次随访时上述观察指标的变化。使用配对样本t检验或非参数检验分析治疗前后是否存在差异。结果:共纳入29例患者,男22例,女7例; 年龄为29～54岁,平均为(44.38±5.51)岁。平均手术时间为(113.21±8.38)min,手术出血量为(142.79±12.80)mL。与术前相比,术后VAS评分、JOA评分及ASIA评分明显改善,差异有统计学意义(P<0.05); 与术前相比,术后1周手术节段高度增加,差异有统计学意义(P<0.05); 末次随访时手术节段高度与术后1周相比下降,差异有统计学意义(P<0.05),与术前相比手术节段高度增加,差异无统计学意义(P>0.05)。末次随访时骨折获得有效融合。结论:Ⅰ期全麻下洛阳正骨手法复位有利于脱位复位,联合颈椎前路手术治疗下颈椎骨折脱位有效。
Abstract:
Objective:To explore the clinical efficacy of Luoyang bone-setting manipulation combined with anterior cervical surgery under stage Ⅰ general anesthesia for lower cervical fracture and dislocation.Methods:Patients with lower cervical fracture dislocation treated from August 2020 to January 2023 were retrospectively analyzed.We set up an Excel database.VAS score,JOA score,ASIA score,height of operated segments,and interbody fusion rate at the final follow-up were used as observations.Paired-sample t-tests or nonparametric tests were used to analyze whether differences existed before and after treatment.Results:A total of 29 patients,22 males and 7 females,aged 2954 years old with a mean of(44.38±5.51)years old were included.Mean operative time(113.21±8.38)min and operative bleeding(142.79±12.80)mL.Postoperative VAS scores,JOA scores,and ASIA scores were significantly improved compared with preoperative scores(P<0.05).Increased height of operated segments at 1 week postoperatively compared with preoperative(P<0.05).Decrease in surgical segment height at the final follow-up compared with 1 week postoperatively(P<0.05).Increased height of oper- ated segments compared to preoperative(P>0.05).Effective fusion was obtained at final follow-up.Conclusion:Luoyang bone-setting manipulation under Stage Ⅰ General Anesthesia is conducive to dislocation,and combined with anterior cervical spine surgery can effectively treat lower cervical vertebral fracture dislocation.

参考文献/References:

[1] 栗林,周英杰,王寅,等.手术治疗下颈椎骨折脱位的研究进展[J].中国脊柱脊髓杂志,2024,34(4):438-443.
[2] NGO L M,AIZAWA T,HOSHIKAWA T,et al.Fracture and contralateral dislocation of the twin facet joints of the lower cervical spine[J].Eur Spine J,2012,21(2):282-288.
[3] 杨孝军,孙烨,韩雪,等.颈前路零切迹椎间融合器联合锁定钛板内固定治疗下颈椎骨折脱位伴脊髓损伤疗效观察[J].中国骨与关节损伤杂志,2023,38(11):1121-1125.
[4] RYAN S,PUGELY A,BRANSFORD R,et al.Fracture-dislocations of the subaxial cervical spine[J].Seminars in Spine Surgery,2024,36(2):25-29.
[5] 周方,田云,姬洪全,等.Ⅰ期全身麻醉下快速牵引复位及前路减压融合治疗下颈椎脱位[J].中华创伤杂志,2005,21(z1):26-29.
[6] 周英杰,柴旭斌,郑怀亮,等.前路撑开撬拨复位固定治疗下颈椎骨折脱位伴关节突绞锁的效果[J].中华创伤杂志,2016,32(11):1002-1008.
[7] 李东方,周英杰,史相钦,等.平乐正骨手法在下颈椎骨折脱位复位中的作用[J].中华中医药杂志,2018,33(2):792-794.
[8] 郭维淮.平乐正骨[M].北京:人民卫生出版社,2008:13-14.
[9] ALLEN B L Jr,FERGUSON R L,LEHMANN T R,et al.A mechanistic classification of closed,indirect fractures and dislocations of the lower cervical spine[J].Spine(Phila Pa 1976),1982,7(1):1-27.
[10] ECK K R,LENKE L G,BRIDWELL K H,et al.Radiographic assessment of anterior titanium mesh cages[J].J Spinal Disord,2000,13(6):501-510.
[11] 李玉伟,王海蛟,严晓云,等.颈前路减压零切迹椎间融合器与钉板系统内固定治疗脊髓型颈椎病的疗效比较[J].中华骨科杂志,2015,35(11):1136-1141.
[12] JOO Y H,LEE J W,KWON K Y,et al.Comparison of fusion with cage alone and plate instrumentation in two-level cervical degenerative disease[J].J Korean Neurosurg Soc,2010,48(4):342-346.
[13] SOLIMAN M A R,AGUIRRE A O,KUO C C,et al.A novel cervical vertebral bone quality score independently predicts cage subsidence after anterior cervical diskectomy and fusion[J].Neurosurgery,2023,92(4):779-786.
[14] WANG L,WANG H,WANG C,et al.Comparative study of halo-vest reduction and skull traction reduction in the treatment of cervical fracture dislocation in patients with ankylosing spondylitis[J].Front Surg,2023,10:1129809.
[15] 宋晓飞,刘念,刘瑜,等.显微镜辅助治疗下颈椎骨折脱位并脊髓损伤[J].中国矫形外科杂志,2023,31(14):1270-1274.
[16] MIAO D C,QI C,WANG F,et al.Management of severe lower cervical facet dislocation without vertebral body fracture using skull traction and an anterior approach[J].Med Sci Monit,2018,24:1295-1302.
[17] SAMUEL S,LIN J L,SMITH M M,et al.Subaxial injury classification scoring system treatment recommendations:external agreement study based on retrospective review of 185 patients[J].Spine(Phila Pa 1976),2015,40(3):137-142.
[18] 郝定均,杨俊松,刘团江,等.从仿生学角度论下颈椎骨折脱位的治疗[J].中华创伤骨科杂志,2022,24(7):553-557.
[19] 简伟,吴广森,隰建成,等.颅骨牵引复位配合颈前路减压融合术治疗下颈椎骨折脱位合并关节突绞锁的临床研究[J].中国医药导报,2019,16(36):85-88.
[20] HAN Y,XIA Q,HU Y C,et al.Simultaneously combined anterior-posterior approaches for subaxial cervical circumferential reconstruction in a sitting position[J].Orthop Surg,2015,7(4):371-374.
[21] 彭斯伟,肖艳,陈鹏,等.中医骨伤“筋骨”与“筋骨关联”探析[J].福建中医药,2024,55(2):25-27.
[22] 张向东,廉杰,赵启,等.平乐正骨“筋滞骨错”理论的辩证思维[J].中医正骨,2017,29(11):44-45.
[23] 王楠,赵明宇,寇赵淅,等.基于平乐正骨筋滞骨错理论探讨肩周炎的病机及治疗方法[J].中医正骨,2023,35(6):56-58.
[24] 翁溥男,翁财,胡微,等.基于筋骨理论探析筋骨失衡分型及治疗思路[J].亚太传统医药,2024,20(3):211-214.
[25] 元唯安,詹红生,杜国庆.论“筋主骨从”观念在慢性筋骨病损诊疗中的临床意义[J].上海中医药杂志,2019,53(9):12-15.
[26] EISMONT F J,ARENA M J,GREEN B A.Extrusion of an intervertebral disc associated with traumatic subluxation or dislocation of cervical facets:case report[J].J Bone Joint Surg Am,1991,73(10):1555-1560.
[27] 赵海洋,李野,陈晶,等.外伤性颈椎间盘撕裂的诊断和治疗策略[J].中国脊柱脊髓杂志,2019,29(9):791-798.
[28] 管恩超,蒋盛旦,王宇仁,等.颈椎间盘损伤影像学诊断的可靠性和一致性分析[J].中华骨与关节外科杂志,2017,10(5):361-367.
[29] 徐军平,关平,宋江润,等.早期全麻下手法牵引复位治疗下颈椎骨折并关节突关节脱位23例[J].中国中医骨伤科杂志,2017,25(11):52-55.
[30] 唐辉,徐永清,尹德宏,等.合并关节突交锁的下颈椎骨折脱位的前路手术[J].中国矫形外科杂志,2023,31(3):279-282.
[31] 公伟,刘勇,刘鹏.椎间融合器联合锁定钛板在下颈椎骨折脱位前路术后早期稳定性的临床研究[J].生物骨科材料与临床研究,2020,17(3):29-32.
[32] 韦学昌,董胜利,刘帅,等.前后路联合手术治疗颈椎骨折脱位并脊髓损伤的临床疗效[J].临床外科杂志,2019,27(12):1083-1085.

备注/Memo

备注/Memo:
基金项目:河南省中医药科学研究专项课题(20-21ZY1064)
△通信作者 E-mail:156295205@qq.com
更新日期/Last Update: 2025-03-10